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Ye SY, Zhao Y, Liu ZB, Luo CP, Xiong JW, Zhan JQ, Li YH, Wei B, Chen CN, Yang YJ. Corrigendum: Lower serum insulin-like growth factor 2 level in patients with bipolar disorder is associated with the severity of manic symptoms during manic episodes. Front Psychiatry 2024; 15:1408899. [PMID: 38680781 PMCID: PMC11046308 DOI: 10.3389/fpsyt.2024.1408899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2024] [Accepted: 04/02/2024] [Indexed: 05/01/2024] Open
Abstract
[This corrects the article DOI: 10.3389/fpsyt.2024.1354999.].
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Affiliation(s)
- Shi-Yi Ye
- Department of Psychiatry and Biological Psychiatry Laboratory, Jiangxi Mental Hospital & Affiliated Mental Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China
- The 3 Clinical Medical College, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China
| | - Ying Zhao
- Department of Pharmacy, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Zhao-Bo Liu
- Department of Psychiatry, Third People’s Hospital of Ji′an City, Ji′an, China
| | - Cui-Pin Luo
- Department of Psychiatry and Biological Psychiatry Laboratory, Jiangxi Mental Hospital & Affiliated Mental Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China
| | - Jian-Wen Xiong
- Department of Psychiatry and Biological Psychiatry Laboratory, Jiangxi Mental Hospital & Affiliated Mental Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China
- Nanchang City Key Laboratory of Biological Psychiatry, Jiangxi Provincial Clinical Research Center on Mental Disorders, Jiangxi Mental Hospital, Nanchang, Jiangxi, China
| | - Jin-Qiong Zhan
- Department of Psychiatry and Biological Psychiatry Laboratory, Jiangxi Mental Hospital & Affiliated Mental Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China
- Nanchang City Key Laboratory of Biological Psychiatry, Jiangxi Provincial Clinical Research Center on Mental Disorders, Jiangxi Mental Hospital, Nanchang, Jiangxi, China
| | - Yi-Heng Li
- Department of Psychiatry and Biological Psychiatry Laboratory, Jiangxi Mental Hospital & Affiliated Mental Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China
- Nanchang City Key Laboratory of Biological Psychiatry, Jiangxi Provincial Clinical Research Center on Mental Disorders, Jiangxi Mental Hospital, Nanchang, Jiangxi, China
| | - Bo Wei
- Department of Psychiatry and Biological Psychiatry Laboratory, Jiangxi Mental Hospital & Affiliated Mental Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China
- Nanchang City Key Laboratory of Biological Psychiatry, Jiangxi Provincial Clinical Research Center on Mental Disorders, Jiangxi Mental Hospital, Nanchang, Jiangxi, China
| | - Chun-Nuan Chen
- Department of Neurology, The Second Clinical Medical College, The Second Affiliated Hospital, Fujian Medical University, Quanzhou, China
| | - Yuan-Jian Yang
- Department of Psychiatry and Biological Psychiatry Laboratory, Jiangxi Mental Hospital & Affiliated Mental Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China
- Nanchang City Key Laboratory of Biological Psychiatry, Jiangxi Provincial Clinical Research Center on Mental Disorders, Jiangxi Mental Hospital, Nanchang, Jiangxi, China
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Ye SY, Zhao Y, Liu ZB, Luo CP, Xiong JW, Zhan JQ, Li YH, Wei B, Chen CN, Yang YJ. Lower serum insulin-like growth factor 2 level in patients with bipolar disorder is associated with the severity of manic symptoms during manic episodes. Front Psychiatry 2024; 15:1354999. [PMID: 38563028 PMCID: PMC10982374 DOI: 10.3389/fpsyt.2024.1354999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Accepted: 03/04/2024] [Indexed: 04/04/2024] Open
Abstract
Objective Accumulating evidence has indicated that neurodevelopmental defects may underlie the pathophysiology of bipolar disorder (BD). Insulin-like growth factors (IGFs) are a family of neurotrophic factors that are essential for the survival and development of neurons. The present study aims to investigate whether IGF-2 signaling is implicated in the pathophysiological processes of BD. Method 50 healthy controls and 78 patients with BD, including 23 patients who diagnosed acute depressive episode and 55 patients who diagnosed acute manic episode, were recruited in this study. The 17-item Hamilton Depression Rating Scale (HAMD-17) and the Young Mania Rating Scale (YMRS) were used to assess the severity of the depressive and manic symptoms, respectively. The serum IGF-2 level was determined by an enzyme-linked immunosorbent assay (ELISA). The Kolmogorov-Smirnov and Mann-Whitney U tests were used for between-group comparisons and spearman analysis was used to analyze correlations. Results Patients with BD had lower serum IGF-2 levels (66.08 ± 21.22 ng/ml) when compared to healthy controls (88.72 ± 31.55 ng/ml). BD patients were divided into manic episode and depressive episode subgroups. We found that serum IGF-2 levels were reduced in both the mania and depression subgroups (mania: 67.19 ± 21.52 ng/ml, depression: 63.43 ± 20.67 ng/ml; P < 0.001), while no significant difference was observed between two groups (P > 0.05). Spearman correlation analyses revealed that the levels of serum IGF-2 were negatively correlated with the YMRS scores in BD patients (r = -0.522, P < 0.001). Furthermore, IGF-2 was found to be an independent contributor to the severity of symptoms in patients with manic episodes (B = -0.610, t = -5.299, P < 0.001). Conclusion Lower serum IGF-2 levels were found in BD patients and correlated with the severity of the manic symptoms in these patients during manic episodes. These results suggest that reduced IGF-2 levels might be involved in the pathophysiology of BD, and serum IGF-2 could be a peripheral biomarker for the evaluation of the severity of manic symptoms in BD patients.
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Affiliation(s)
- Shi-Yi Ye
- Department of Psychiatry and Biological Psychiatry Laboratory, Jiangxi Mental Hospital & Affiliated Mental Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China
- The 3 Clinical Medical College, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China
| | - Ying Zhao
- Department of Pharmacy, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Zhao-Bo Liu
- Department of Psychiatry, Third People’s Hospital of Ji′an City, Ji′an, China
| | - Cui-Pin Luo
- Department of Psychiatry and Biological Psychiatry Laboratory, Jiangxi Mental Hospital & Affiliated Mental Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China
| | - Jian-Wen Xiong
- Department of Psychiatry and Biological Psychiatry Laboratory, Jiangxi Mental Hospital & Affiliated Mental Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China
- Nanchang City Key Laboratory of Biological Psychiatry, Jiangxi Provincial Clinical Research Center on Mental Disorders, Jiangxi Mental Hospital, Nanchang, Jiangxi, China
| | - Jin-Qiong Zhan
- Department of Psychiatry and Biological Psychiatry Laboratory, Jiangxi Mental Hospital & Affiliated Mental Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China
- Nanchang City Key Laboratory of Biological Psychiatry, Jiangxi Provincial Clinical Research Center on Mental Disorders, Jiangxi Mental Hospital, Nanchang, Jiangxi, China
| | - Yi-Heng Li
- Department of Psychiatry and Biological Psychiatry Laboratory, Jiangxi Mental Hospital & Affiliated Mental Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China
- Nanchang City Key Laboratory of Biological Psychiatry, Jiangxi Provincial Clinical Research Center on Mental Disorders, Jiangxi Mental Hospital, Nanchang, Jiangxi, China
| | - Bo Wei
- Department of Psychiatry and Biological Psychiatry Laboratory, Jiangxi Mental Hospital & Affiliated Mental Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China
- Nanchang City Key Laboratory of Biological Psychiatry, Jiangxi Provincial Clinical Research Center on Mental Disorders, Jiangxi Mental Hospital, Nanchang, Jiangxi, China
| | - Chun-Nuan Chen
- Department of Neurology, The Second Clinical Medical College, The Second Affiliated Hospital, Fujian Medical University, Quanzhou, China
| | - Yuan-Jian Yang
- Department of Psychiatry and Biological Psychiatry Laboratory, Jiangxi Mental Hospital & Affiliated Mental Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China
- Nanchang City Key Laboratory of Biological Psychiatry, Jiangxi Provincial Clinical Research Center on Mental Disorders, Jiangxi Mental Hospital, Nanchang, Jiangxi, China
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Chen P, Sajatovic M, Briggs FBS, Mulsant B, Dols AA, Gildengers A, Yala J, Beunders AJM, Blumberg HP, Rej S, Forlenza OV, Jimenez E, Schouws S, Orhan M, Sutherland AN, Vieta E, Tsai S, Sarna K, Eyler LT. Sociodemographic and clinical characteristics of people with oldest older age bipolar disorder in a global sample: Results from the global aging and geriatric experiments in bipolar disorder project. Int J Geriatr Psychiatry 2024; 39:e6073. [PMID: 38393311 DOI: 10.1002/gps.6073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2023] [Accepted: 02/14/2024] [Indexed: 02/25/2024]
Abstract
OBJECTS Studies of older age bipolar disorder (OABD) have mostly focused on "younger old" individuals. Little is known about the oldest OABD (OOABD) individuals aged ≥70 years old. The Global Aging and Geriatric Experiments in Bipolar Disorder (GAGE-BD) project provides an opportunity to evaluate the OOABD group to understand their characteristics compared to younger groups. METHODS We conducted cross-sectional analyses of the GAGE-BD database, an integrated, harmonized dataset from 19 international studies. We compared the sociodemographic and clinical characteristics of those aged <50 (YABD, n = 184), 50-69 (OABD, n = 881), and ≥70 (OOABD, n = 304). To standardize the comparisons between age categories and all characteristics, we used multinomial logistic regression models with age category as the dependent variable, with each characteristic as the independent variable, and clustering of standard errors to account for the correlation between observations from each of the studies. RESULTS OOABD and OABD had lower severity of manic symptoms (Mean YMRS = 3.3, 3.8 respectively) than YABD (YMRS = 7.6), and lower depressive symptoms (% of absent = 65.4%, and 59.5% respectively) than YABD (18.3%). OOABD and OABD had higher physical burden than YABD, especially in the cardiovascular domain (prevalence = 65% in OOABD, 41% in OABD and 17% in YABD); OOABD had the highest prevalence (56%) in the musculoskeletal domain (significantly differed from 39% in OABD and 31% in YABD which didn't differ from each other). Overall, OOABD had significant cumulative physical burden in numbers of domains (mean = 4) compared to both OABD (mean = 2) and YABD (mean = 1). OOABD had the lowest rates of suicidal thoughts (10%), which significantly differed from YABD (26%) though didn't differ from OABD (21%). Functional status was higher in both OOABD (GAF = 63) and OABD (GAF = 64), though only OABD had significantly higher function than YABD (GAF = 59). CONCLUSIONS OOABD have unique features, suggesting that (1) OOABD individuals may be easier to manage psychiatrically, but require more attention to comorbid physical conditions; (2) OOABD is a survivor cohort associated with resilience despite high medical burden, warranting both qualitative and quantitative methods to better understand how to advance clinical care and ways to age successfully with BD.
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Affiliation(s)
- Peijun Chen
- Department of Psychiatry, Geriatric Psychiatry Division, Geriatric Research, Education and Clinical Center (GRECC), Case Western Reserve University School of Medicine, VA Northeast Ohio Healthcare System, Cleveland, Ohio, USA
| | - Martha Sajatovic
- Department of Psychiatry, Case Western Reserve University School of Medicine, University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA
| | - Farren B S Briggs
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Benoit Mulsant
- Department of Psychiatry, University of Toronto, Center for Addiction & Mental Health, Toronto, Ontario, Canada
| | - Annemiek A Dols
- GGZ inGeest, Amsterdam, the Netherlands
- Amsterdam UMC, Location Vrije Universiteit Amsterdam, Psychiatry, Amsterdam, the Netherlands
- Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
- Amsterdam Neuroscience, Amsterdam, the Netherlands
| | - Ariel Gildengers
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Joy Yala
- Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
| | - Alexandra J M Beunders
- GGZ inGeest, Amsterdam, the Netherlands
- Amsterdam UMC, Location Vrije Universiteit Amsterdam, Psychiatry, Amsterdam, the Netherlands
- Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
| | - Hilary P Blumberg
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, USA
| | - Soham Rej
- Department of Psychiatry, Jewish General Hospital/Lady Davis Institute, McGill University, Montreal, Quebec, Canada
| | - Orestes V Forlenza
- Department and Institute of Psychiatry, Laboratory of Neuroscience (LIM-27), HCFMUSP, Faculdade de Medicina da Universidade de São Paulo, São Paulo, São Paulo, Brazil
| | - Esther Jimenez
- Bipolar and Depressive Disorders Unit, Hospital Clinic, University of Barcelona, Institute of Neuroscience, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
- Department of Psychiatry, Hospital Universitario de Alava, BIOARABA, UPV/EHU, CIBERSAM, Vitoria, Spain
| | - Sigfried Schouws
- GGZ inGeest, Amsterdam, the Netherlands
- Amsterdam UMC, Location Vrije Universiteit Amsterdam, Psychiatry, Amsterdam, the Netherlands
| | - Melis Orhan
- Department of Clinical Psychology, Leiden University, Leiden, the Netherlands
| | - Ashley N Sutherland
- Department of Psychiatry, University of California San Diego, San Diego, California, USA
- Desert-Pacific Mental Illness Research Education and Clinical Center, VA San Diego Healthcare System, San Diego, California, USA
| | - Eduard Vieta
- Bipolar and Depressive Disorders Unit, Hospital Clinic, Institute of Neuroscience, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - Shangying Tsai
- Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Kaylee Sarna
- Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
| | - Lisa T Eyler
- Department of Psychiatry, University of California San Diego, San Diego, California, USA
- Desert-Pacific Mental Illness Research Education and Clinical Center, VA San Diego Healthcare System, San Diego, California, USA
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Oliva V, De Prisco M, Fico G, Possidente C, Fortea L, Montejo L, Anmella G, Hidalgo-Mazzei D, Grande I, Murru A, Fornaro M, de Bartolomeis A, Dodd A, Fanelli G, Fabbri C, Serretti A, Vieta E, Radua J. Correlation between emotion dysregulation and mood symptoms of bipolar disorder: A systematic review and meta-analysis. Acta Psychiatr Scand 2023; 148:472-490. [PMID: 37740499 DOI: 10.1111/acps.13618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 08/28/2023] [Accepted: 09/05/2023] [Indexed: 09/24/2023]
Abstract
BACKGROUND Emotion dysregulation (ED) is a transdiagnostic construct characterized by difficulties regulating intense emotions. People with bipolar disorder (BD) are more likely to show ED and use maladaptive emotion regulation strategies than adaptive ones. However, little is known about whether ED in BD is a trait or it is rather an epiphenomenon of mood symptoms. METHODS We conducted a systematic review and meta-analysis of the evidence across major literature databases reporting correlations between measures of emotion regulation (overall ED and different emotion regulation strategies) and measures of depressive and (hypo)manic symptoms in BD from inception until April 12th, 2022. RESULTS Fourteen studies involving 1371 individuals with BD were included in the qualitative synthesis, of which 11 reported quantitative information and were included in the meta-analysis. ED and maladaptive strategies were significantly higher during periods with more severe mood symptoms, especially depressive ones, while adaptive strategies were lower. CONCLUSION ED significantly correlates with BD symptomatology, and it mainly occurs during mood alterations. ED may be a target for specific psychotherapeutic and pharmacological treatments, according to precision psychiatry. However, further studies are needed, including patients with mood episodes and longitudinal design, to provide more robust evidence and explore the causal direction of the associations.
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Affiliation(s)
- Vincenzo Oliva
- Departament de Medicina, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona (UB), Barcelona, Spain
- Bipolar and Depressive Disorders Unit, Hospìtal Clinic de Barcelona, Barcelona, Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Michele De Prisco
- Departament de Medicina, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona (UB), Barcelona, Spain
- Bipolar and Depressive Disorders Unit, Hospìtal Clinic de Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
| | - Giovanna Fico
- Departament de Medicina, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona (UB), Barcelona, Spain
- Bipolar and Depressive Disorders Unit, Hospìtal Clinic de Barcelona, Barcelona, Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Chiara Possidente
- Departament de Medicina, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona (UB), Barcelona, Spain
- Bipolar and Depressive Disorders Unit, Hospìtal Clinic de Barcelona, Barcelona, Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Lydia Fortea
- Departament de Medicina, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona (UB), Barcelona, Spain
- Bipolar and Depressive Disorders Unit, Hospìtal Clinic de Barcelona, Barcelona, Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Laura Montejo
- Departament de Medicina, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona (UB), Barcelona, Spain
- Bipolar and Depressive Disorders Unit, Hospìtal Clinic de Barcelona, Barcelona, Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
| | - Gerard Anmella
- Departament de Medicina, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona (UB), Barcelona, Spain
- Bipolar and Depressive Disorders Unit, Hospìtal Clinic de Barcelona, Barcelona, Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
| | - Diego Hidalgo-Mazzei
- Departament de Medicina, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona (UB), Barcelona, Spain
- Bipolar and Depressive Disorders Unit, Hospìtal Clinic de Barcelona, Barcelona, Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Iria Grande
- Departament de Medicina, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona (UB), Barcelona, Spain
- Bipolar and Depressive Disorders Unit, Hospìtal Clinic de Barcelona, Barcelona, Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
| | - Andrea Murru
- Departament de Medicina, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona (UB), Barcelona, Spain
- Bipolar and Depressive Disorders Unit, Hospìtal Clinic de Barcelona, Barcelona, Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Michele Fornaro
- Section of Psychiatry, Department of Neuroscience, Reproductive Science and Odontostomatology, Federico II University of Naples, Naples, Italy
| | - Andrea de Bartolomeis
- Section of Psychiatry, Department of Neuroscience, Reproductive Science and Odontostomatology, Federico II University of Naples, Naples, Italy
| | - Alyson Dodd
- Department of Psychology, Faculty of Health & Life Sciences, Northumbria University, Newcastle-upon-Tyne, UK
| | - Giuseppe Fanelli
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
- Department of Human Genetics, Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands
| | - Chiara Fabbri
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
- Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Alessandro Serretti
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Eduard Vieta
- Departament de Medicina, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona (UB), Barcelona, Spain
- Bipolar and Depressive Disorders Unit, Hospìtal Clinic de Barcelona, Barcelona, Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
| | - Joaquim Radua
- Departament de Medicina, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona (UB), Barcelona, Spain
- Bipolar and Depressive Disorders Unit, Hospìtal Clinic de Barcelona, Barcelona, Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
- Department of Clinical Neuroscience, Centre for Psychiatric Research and Education, Karolinska Institutet, Stockholm, Sweden
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
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Schweiger V, Perini G, Del Piccolo L, Perlini C, Donisi V, Gottin L, Martini A, Donadello K, Del Balzo G, Moro V, Secchettin E, Polati E. Bipolar Spectrum Symptoms in Patients with Fibromyalgia: A Dimensional Psychometric Evaluation of 120 Patients. Int J Environ Res Public Health 2022; 19:16395. [PMID: 36554275 PMCID: PMC9779073 DOI: 10.3390/ijerph192416395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 12/02/2022] [Accepted: 12/04/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND Fibromyalgia Syndrome (FMS) is characterized by chronic widespread pain, fatigue, unrefreshing sleep and cognitive dysfunction. Depressive and manic symptoms are often reported in FMS patients' history. The aim of this study was to evaluate the prevalence of bipolar spectrum symptoms (BSS) and to correlate these with quality of life (QoL) scores and antidepressant treatment. METHODS From October 2017 to July 2018, a battery of QoL questionnaires (FIQ, PSQI and SF-12) was administered to 120 FMS patients after a clinical examination. The MOODS-SR lifetime questionnaire was then remotely administered to the patients included in the study. RESULTS The presence of depressive and manic lifetime symptoms was found, in line with the results of the available literature. A correlation was found between the history of depressive symptoms and the severity of FIQ and SF-12 scores. Despite a low statistical strength, a trend toward a correlation between a history of manic symptoms and SNRI treatment was detected. CONCLUSIONS The correlation between the MOOD-depressive domains and poor QoL is in line with the available literature. Further studies are needed to corroborate these findings and to elucidate the relationship between manic symptoms and SNRI treatment.
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Affiliation(s)
- Vittorio Schweiger
- Department of Surgery, Dentistry, Paediatrics and Gynaecology, Pain Therapy Center, University of Verona, 37124 Verona, Italy
| | - Giovanni Perini
- Department of Surgery, Dentistry, Paediatrics and Gynaecology, Pain Therapy Center, University of Verona, 37124 Verona, Italy
| | - Lidia Del Piccolo
- Department of Neurosciences, Biomedicine and Movement Sciences, Clinical Psychology, University of Verona, 37124 Verona, Italy
| | - Cinzia Perlini
- Department of Neurosciences, Biomedicine and Movement Sciences, Clinical Psychology, University of Verona, 37124 Verona, Italy
| | - Valeria Donisi
- Department of Neurosciences, Biomedicine and Movement Sciences, Clinical Psychology, University of Verona, 37124 Verona, Italy
| | - Leonardo Gottin
- Department of Surgery, Dentistry, Paediatrics and Gynaecology, Pain Therapy Center, University of Verona, 37124 Verona, Italy
| | - Alvise Martini
- Department of Surgery, Dentistry, Paediatrics and Gynaecology, Pain Therapy Center, University of Verona, 37124 Verona, Italy
| | - Katia Donadello
- Department of Surgery, Dentistry, Paediatrics and Gynaecology, Pain Therapy Center, University of Verona, 37124 Verona, Italy
| | - Giovanna Del Balzo
- Department of Medicine and Public Health, University of Verona, 37124 Verona, Italy
| | - Valentina Moro
- NPSY-Lab.VR, Department of Human Sciences, University of Verona, 37124 Verona, Italy
| | - Erica Secchettin
- Department of Surgery, Dentistry, Paediatrics and Gynaecology, Pain Therapy Center, University of Verona, 37124 Verona, Italy
| | - Enrico Polati
- Department of Surgery, Dentistry, Paediatrics and Gynaecology, Pain Therapy Center, University of Verona, 37124 Verona, Italy
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Abstract
OBJECTIVES To evaluate the odds for bipolar disorder (BP) mania and depression-related hospitalization due to cannabis use disorders (CUD). METHODS We conducted a cross-sectional study using the national inpatient sample (NIS), and included adult BP hospitalizations sub-grouped by manic (N = 209,785) versus depressive episodes (N = 170480). A logistic regression model was used to evaluate adjusted odds ratio (aOR) of association between CUD and BP-mania-related hospitalizations and was adjusted for demographics confounders, psychiatric comorbidities and other substance use disorders (SUD). RESULTS Comorbidities were less prevalent in BP mania compared to BP depression: anxiety disorders (22.7% vs. 35.3%), PTSD (8.7% vs. 14.3%), and personality disorders (15.4% vs. 20.5%). Among SUD, methamphetamine (aOR 1.27, 95%CI 1.22 - 1.32) and CUD (aOR 1.53, 95%CI 1.50 - 1.56) had increased odds for hospitalization for BP mania. CONCLUSION CUD increases the odds for hospitalization for BP manic episode by 53%. Due to the rising prevalence of cannabis use among patients with BP it is important to provide substance use counseling/psychoeducation and discourage cannabis use among youth to prevent long-term adverse consequences.
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Affiliation(s)
- Rikinkumar S Patel
- Department of Psychiatry, Griffin Memorial Hospital, Norman, Oklahoma, USA
| | - Zainab Cheema
- Department of Psychiatry, Griffin Memorial Hospital, Norman, Oklahoma, USA
| | - Ashima Singla
- Department of Psychiatry, Griffin Memorial Hospital, Norman, Oklahoma, USA
| | - Miglia Cornejo
- School of Osteopathic Medicine, Arizona, A.T. Still University, Mesa, Arizona, USA
| | - Geetika Verma
- Department of Psychiatry, Griffin Memorial Hospital, Norman, Oklahoma, USA
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Lomastro MJ, Valerio MP, Szmulewicz AG, Martino DJ. Manic morbidity and executive function impairment as determinants of long-term psychosocial dysfunction in bipolar disorder. Acta Psychiatr Scand 2021; 144:72-81. [PMID: 33792890 DOI: 10.1111/acps.13303] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Accepted: 03/28/2021] [Indexed: 01/02/2023]
Abstract
OBJECTIVE In this study, we aimed to evaluate the role of cognitive performance and measures of clinical course-including both syndromal and subsyndromal symptomatology-as determinants of the functional outcome of patients with Bipolar Disorder (BD) during a mean follow-up period of more than 4 years. METHODS Seventy patients with euthymic BD completed a neurocognitive battery at study entry. Clinical course was assessed prospectively for a period longer than 48 months by two measures: time spent ill (documented using a modified life charting technique) and density of affective episodes (defined as the number of depressive and hypo/manic episodes per year of follow-up). Psychosocial functioning was assessed during euthymia using the Functioning Assessment Short Test (FAST) total score at the end of follow-up period. RESULTS Baseline deficits in phonological fluency, a measure of executive functions (β = -2.49; 95% CI = -3.98, -0.99), and density of hypo/manic episodes during follow-up (β = 6.54; 95% CI = 0.43, 12.65) were independently associated with FAST total score at the end of study. CONCLUSIONS Although interrelated, manic morbidity and executive function impairments independently contribute to long-term psychosocial dysfunction in BD and could be potential targets of intervention.
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Affiliation(s)
| | - Marina P Valerio
- Psychiatric Emergencies Hospital Torcuato de Alvear, Buenos Aires, Argentina.,National Council of Scientific and Technical Research (CONICET, Buenos Aires, Argentina
| | | | - Diego J Martino
- National Council of Scientific and Technical Research (CONICET, Buenos Aires, Argentina.,Institute of Cognitive and Translational Neuroscience (INCyT, INECO Foundation, Favaloro University, Buenos Aires, Argentina
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Charatcharungkiat N, Luby J, Tillman R, Vogel A. The association between manic symptoms in adolescence and preschool symptoms: The importance of family history. Bipolar Disord 2021; 23:303-311. [PMID: 33450097 PMCID: PMC8169556 DOI: 10.1111/bdi.13046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Revised: 11/10/2020] [Accepted: 12/22/2020] [Indexed: 11/29/2022]
Abstract
OBJECTIVES First, to investigate whether specific manic symptoms in preschool predict manic symptom severity in adolescence. Second, to investigate the interaction between family history (FH) of bipolar disorder (BP) and preschool manic symptoms in predicting later adolescent manic symptom severity. METHODS This analysis utilized data from the Preschool Depression Study (PDS) which followed 306 preschoolers aged 3-6 years over time since 2003. Only subjects who had data both at baseline (age 3-6 years) and at or after age 12 were included (n = 122). Baseline manic symptom severity scores and diagnoses were assessed by the Preschool Age Psychiatric Assessment (PAPA). Manic symptoms severity at age ≥12 was assessed by the Kiddie Mania Rating Scale (KMRS). FH were ascertained by Family Interview for Genetic Studies (FIGS). Multilevel models of KMRS total score at age ≥12 by preschool mania symptoms with gender, baseline age, baseline ADHD, as well as baseline MDD diagnosis as covariates, and false discovery rate correction were used in statistical analysis. RESULTS Hypertalkativity, flight of ideas, uninhibited gregariousness, decreased need for sleep (DNFS), and increased motor pressure/ motor activity/ energy in preschool were associated with increased KMRS score at age ≥12. Racing thoughts, inappropriate laughing, and DNFS in early childhood were associated with higher manic symptoms in adolescence in subjects with FH of BP compared to those without FH. CONCLUSION The longitudinal clinical importance of displaying manic symptoms (racing thoughts, inappropriate laughing, and DNFS) in early childhood varies by FH. Among the aforementioned symptoms, DNFS was a robust predictor of later manic symptoms. Assessing FH of BP is very important in clinical risk prediction from early childhood.
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Affiliation(s)
- Natchanan Charatcharungkiat
- Early Emotional Development Program, William Greenleaf Eliot Division of Child and Adolescent Psychiatry, Department of Psychiatry, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
| | - Joan Luby
- Early Emotional Development Program, William Greenleaf Eliot Division of Child and Adolescent Psychiatry, Department of Psychiatry, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
| | - Rebecca Tillman
- Early Emotional Development Program, William Greenleaf Eliot Division of Child and Adolescent Psychiatry, Department of Psychiatry, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
| | - Alecia Vogel
- Early Emotional Development Program, William Greenleaf Eliot Division of Child and Adolescent Psychiatry, Department of Psychiatry, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
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9
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Diler RS, Goldstein TR, Hafeman D, Merranko J, Liao F, Goldstein BI, Hower H, Gill MK, Hunt J, Yen S, Keller MB, Axelson D, Strober M, Iyengar S, Ryan ND, Birmaher B. Distinguishing Bipolar Depression from Unipolar Depression in Youth: Preliminary Findings. J Child Adolesc Psychopharmacol 2017; 27:310-319. [PMID: 28398819 PMCID: PMC5439419 DOI: 10.1089/cap.2016.0154] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVES To identify mood symptoms that distinguishes bipolar disorder (BP) depression versus unipolar depression in youth during an acute depressive episode. METHODS Youth with BP (N = 30) were compared with youth with unipolar depression (N = 59) during an acute depressive episode using the depression and mania items derived from the Schedule for Affective Disorders and Schizophrenia for Children (K-SADS)-Present Version. The results were adjusted for multiple comparisons, and any significant between-group differences in demographic, nonmood comorbid disorders, and psychiatric family history. RESULTS In comparison with unipolar depressed youth, BP depressed youth had significantly higher scores in several depressive symptoms and all subsyndromal manic symptoms, with the exception of increased goal-directed activity. Among the depressive symptoms, higher ratings of nonsuicidal physical self-injurious acts and mood reactivity, and lower ratings of aches/pains, were the symptoms that best discriminated BP from unipolar depressed youth. Subsyndromal manic symptoms, particularly motor hyperactivity, distractibility, and pressured speech, were higher in BP depressed youth and discriminated BP depressed from unipolar depressed youth. CONCLUSIONS The results of this study suggest that it is possible to differentiate BP depression from unipolar depression based on depressive symptoms, and in particular subsyndromal manic symptoms. If replicated, these results have important clinical and research implications.
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Affiliation(s)
- Rasim Somer Diler
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Tina R. Goldstein
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Danella Hafeman
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - John Merranko
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Fangzi Liao
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Benjamin I. Goldstein
- Department of Psychiatry, Sunnybrook Health Sciences Centre, University of Toronto Faculty of Medicine, Toronto, Canada
| | - Heather Hower
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, Rhode Island
| | - Mary Kay Gill
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Jeffrey Hunt
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, Rhode Island
| | - Shirley Yen
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, Rhode Island
| | - Martin B. Keller
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, Rhode Island
| | - David Axelson
- Department of Psychiatry, Nationwide Children's Hospital, The Ohio State College of Medicine, Columbus, Ohio
| | - Michael Strober
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California
| | - Satish Iyengar
- Department of Statistics, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Neal D. Ryan
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Boris Birmaher
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
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10
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Abstract
OBJECTIVES The enzyme catechol-O-methyltransferase (COMT), which catalyses the degradation of dopamine and norepinephrine, is posited to participate in the pathophysiology of bipolar disorder (BD) and schizophrenia. In support of this notion, rich evidence has documented that the severity of various BD and schizophrenia symptoms is moderated by rs4680, a single nucleotide polymorphism of the COMT gene featuring a valine (Val)-to-methionine (Met) substitution that results in lower catalytic activity. Nevertheless, the specific relevance of COMT enzymatic activity in the pathophysiology of BD and schizophrenia dimensions remains elusive. METHODS We measured COMT catalytic activity in post-mortem prefrontal cortices, striata and cerebella of schizophrenia and BD patients, as well as non-affected controls. These values were then correlated with rs4680 genotypes and psychopathology scores in the last week of life. RESULTS No direct correlation between COMT activity and rs4680 genotypes was found; however, the severity of manic symptoms was highly correlated with COMT activity in the striatum, irrespective of the diagnostic group. CONCLUSIONS These results suggest that COMT striatal activity, but not rs4680 genotype, may serve as a biomarker for manic symptoms. Future studies are warranted to confirm these findings and assess the neurobiological links between COMT striatal activity and manic symptoms.
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Affiliation(s)
- Marco Bortolato
- Department of Pharmacology and Toxicology, College of Pharmacy, University of Utah, Salt Lake City, UT, 84112, USA,Corresponding authors: Marco Bortolato, MD PhD, Department of Pharmacology and Toxicology, University of Utah, 30 2000 E, Salt Lake City, UT 84112, . Jackob Moskovitz, PhD, Department of Pharmacology and Toxicology, University of Kansas, 1251 Wescoe Hall Dr., Lawrence, KS 66045,
| | - Consuelo Walss-Bass
- Department of Psychiatry and Behavioral Science, School of Medicine, University of Texas Health Science Center, Houston, TX, 77054, USA
| | - Peter M. Thompson
- Southwest Brain Bank, Department of Psychiatry, Texas Tech University Health Science Center at El Paso, El Paso TX 79905 USA
| | - Jackob Moskovitz
- Department of Pharmacology and Toxicology, School of Pharmacy, University of Kansas, Lawrence, KS, 66045, USA,Corresponding authors: Marco Bortolato, MD PhD, Department of Pharmacology and Toxicology, University of Utah, 30 2000 E, Salt Lake City, UT 84112, . Jackob Moskovitz, PhD, Department of Pharmacology and Toxicology, University of Kansas, 1251 Wescoe Hall Dr., Lawrence, KS 66045,
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11
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Abstract
Mixed states in bipolar disorder have been neglected, and the data concerning treatment of these conditions have been relatively obscure. To address this, we systematically reviewed published pharmacological treatment data for "mixed states/episodes" in mood disorders, including "with mixed features" in DSM-5. We searched PubMed, MEDLINE, The Cochrane Library, clinicaltrials.gov, and controlled-trials.com (with different combinations of the following keywords: "mixed states/features," "bipolar," "depressive symptoms/bipolar depression," "manic symptoms," "treatment," "DSM-5") through to October 2016. We applied a quality-of-evidence approach: first-degree evidence=randomized placebo-controlled studies of pharmacological interventions used as monotherapy; second-degree evidence=a similar design in the absence of a placebo or of a combination therapy as a comparative group; third-degree evidence=case reports, case series, and reviews of published studies. We found very few primary double-blind, placebo-controlled studies on the treatment of mixed states: the preponderance of available data derives from subgroup analysis performed on studies that originally involved manic patients. Future research should study the effects of treatments in mixed states defined using current criteria.
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12
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Horwitz SM, Storfer-Isser A, Young AS, Youngstrom EA, Taylor HG, Frazier TW, Arnold LE, Fristad MA, Birmaher B, Findling RL. Development of Alcohol and Drug Use in Youth With Manic Symptoms. J Am Acad Child Adolesc Psychiatry 2017; 56:149-156. [PMID: 28117061 PMCID: PMC5302842 DOI: 10.1016/j.jaac.2016.11.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2016] [Revised: 10/25/2016] [Accepted: 11/21/2016] [Indexed: 11/30/2022]
Abstract
OBJECTIVE This analysis examined alcohol and drug use over a 6-year follow-up of children in the Longitudinal Assessment of Manic Symptoms (LAMS) study. METHOD LAMS screened 6- to 12.9-year-old children visiting 9 child outpatient mental health (MH) clinics, using the Parent General Behavior Inventory 10-item mania scale. All children with scores ≥12 and a matched group with scores ≤12 were invited to enroll. Children were assessed every 6 months. Assessments included demographics, family, MH history, child diagnoses, child stress, and alcohol and drug use. Univariate, bivariate, and interval censored survival analyses were conducted. RESULTS Of those >9 years at baseline, 34.9% used alcohol at least once, with 11.9% regular users; 30.1% used drugs at least once, with 16.2% regular users. Predictors of any alcohol use were parental marital status, older age at study entry, a primary diagnosis of disruptive behavior disorders at baseline, and number of impactful child life events. Predictors of regular alcohol use included parental marital status, age, and sustained high mania symptoms over the first 24 months of follow-up. Predictors of any drug use were single parent, parental substance use, and stressful child life events. Predictors of regular drug use were parental marital status, stressful child life events, and a baseline disruptive behavior disorder diagnosis. Baseline medications decreased the risk of regular drug use. CONCLUSION Longitudinal data on youth with elevated manic symptoms suggest that comorbid disruptive behavior disorder, manic symptom burden, family environment, and stress are predictors of initiation and regular use of substances.
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13
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Chan HY, Lee KI. Alcohol withdrawal delirium manifested by manic symptoms in an elderly patient. Psychogeriatrics 2015; 15:62-4. [PMID: 25515164 DOI: 10.1111/psyg.12065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2014] [Revised: 08/12/2014] [Accepted: 08/17/2014] [Indexed: 11/28/2022]
Abstract
Alcohol withdrawal syndrome is a commonly seen problem in psychiatric practice. Alcohol withdrawal delirium is associated with significant morbidity and mortality. Withdrawal symptoms usually include tremulousness, psychotic and perceptual symptoms, seizures, and consciousness disturbance. Herein, we report a case involving a 63-year-old man who had alcohol withdrawal delirium that was manifested mainly by manic symptoms.
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Affiliation(s)
- Hung-Yu Chan
- Department of Psychiatry, Taoyuan Psychiatric Center, Taoyuan, Taiwan; Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan
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14
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Becking K, Boschloo L, Vogelzangs N, Haarman BCM, Riemersma-van der Lek R, Penninx BWJH, Schoevers RA. The association between immune activation and manic symptoms in patients with a depressive disorder. Transl Psychiatry 2013; 3:e314. [PMID: 24150223 PMCID: PMC3818012 DOI: 10.1038/tp.2013.87] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2013] [Revised: 08/28/2013] [Accepted: 09/08/2013] [Indexed: 12/02/2022] Open
Abstract
Although recent studies have shown that immunological processes play an important role in the pathophysiology of mood disorders, immune activation may only be present in specific subgroups of patients. Our study aimed to examine whether immune activation was associated with (a) the presence of manic symptoms and (b) the onset of manic symptoms during 2 years of follow-up in depressed patients. Patients with a depressive disorder at baseline (N=957) and healthy controls (N=430) were selected from the Netherlands Study of Depression and Anxiety. Assessments included lifetime manic symptoms at baseline and two-year follow up, as well as C-reactive protein (CRP), interleukin-6 (IL-6) and tumor necrosis factor alpha (TNF-α) at baseline. Within depressed patients, immune activation was not related to the presence or absence of lifetime manic symptoms at baseline. However, CRP levels were strongly elevated in depressed men who developed manic symptoms compared with those who did not develop manic symptoms over 2 years (P<0.001, Cohen's d=0.89). IL-6 and TNF-α were also higher in depressed men with an onset of manic symptoms, but this association was not significant. However, we found that the onset of manic symptoms was particularly high in men with multiple elevated levels of inflammatory markers. Depressed men who developed manic symptoms during follow-up had increased immunological activity (especially CRP) compared with depressed men who did not develop manic symptoms. Further research should explore whether a treatment approach focusing on inflammatory processes may be more effective in this specific subgroup of depressed patients.
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Affiliation(s)
- K Becking
- Interdisciplinary Center of Psychopathology and Emotion Regulation (ICPE)/University Center Psychiatry (UCP), Department of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands,Interdisciplinary Center of Psychopathology and Emotion Regulation (ICPE)/University Center Psychiatry (UCP), Department of Psychiatry, University Medical Center Groningen, University of Groningen, Sabangplein 20, Groningen 9713 GZ, The Netherlands. E-mail:
| | - L Boschloo
- Interdisciplinary Center of Psychopathology and Emotion Regulation (ICPE)/University Center Psychiatry (UCP), Department of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - N Vogelzangs
- Department of Psychiatry and EMGO+ Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
| | - B C M Haarman
- Interdisciplinary Center of Psychopathology and Emotion Regulation (ICPE)/University Center Psychiatry (UCP), Department of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - R Riemersma-van der Lek
- Interdisciplinary Center of Psychopathology and Emotion Regulation (ICPE)/University Center Psychiatry (UCP), Department of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - B W J H Penninx
- Interdisciplinary Center of Psychopathology and Emotion Regulation (ICPE)/University Center Psychiatry (UCP), Department of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands,Department of Psychiatry and EMGO+ Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands,Department of Psychiatry, Leiden University Medical Center, Leiden, The Netherlands
| | - R A Schoevers
- Interdisciplinary Center of Psychopathology and Emotion Regulation (ICPE)/University Center Psychiatry (UCP), Department of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
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15
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Findling RL, Jo B, Frazier TW, Youngstrom EA, Demeter CA, Fristad MA, Birmaher B, Kowatch RA, Arnold E, Axelson DA, Ryan N, Hauser JC, Brace DJ, Marsh LE, Gill MK, Depew J, Rowles BM, Horwitz SM. The 24-month course of manic symptoms in children. Bipolar Disord 2013; 15:669-79. [PMID: 23799945 PMCID: PMC3762908 DOI: 10.1111/bdi.12100] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2012] [Accepted: 03/28/2013] [Indexed: 11/30/2022]
Abstract
OBJECTIVES The Longitudinal Assessment of Manic Symptoms (LAMS) study was designed to investigate phenomenology and establish predictors of functional outcomes in children with elevated manic symptoms. The purpose of this series of analyses was to determine whether the participants demonstrated different trajectories of parent-reported manic and biphasic symptoms over the first 24 months of follow-up and to describe the clinical characteristics of the trajectories. METHODS The 707 participants were initially aged 6-12 years and ascertained from outpatient clinics associated with the four university-affiliated LAMS sites. There were 621 children whose parents/guardians' ratings scored ≥ 12 on the Parent General Behavior Inventory-10-item Mania Form (PGBI-10M) and a matched random sample of 86 children whose parents/guardians' ratings scored ≤ 11 on the PGBI-10M. Participants were seen every six months after the baseline and their parents completed the PGBI-10M at each visit. RESULTS For the whole sample, manic symptoms decreased over 24 months (linear effect B = -1.15, standard error = 0.32, t = -3.66, p < 0.001). Growth mixture modeling revealed four unique trajectories of manic symptoms. Approximately 85% of the cohort belonged to two classes in which manic symptoms decreased. The remaining ~15% formed two classes (high and rising and unstable) characterized by the highest rates of diagnostic conversion to a bipolar disorder (all p-values < 0.001). CONCLUSIONS Outcomes are not uniform among children with symptoms of mania or at high risk for mania. A substantial minority of clinically referred children shows unstable or steadily increasing manic symptoms, and these patterns have distinct clinical correlates.
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Affiliation(s)
- Robert L Findling
- Division of Child and Adolescent Psychiatry, Johns Hopkins University, Baltimore, MD, USA.
| | - Booil Jo
- Department of Psychiatry and Behavioral Sciences, Center for Interdisciplinary Brain Sciences Research, Stanford University School of Medicine, Stanford, CA
| | - Thomas W Frazier
- Center for Autism, Pediatric Institute, Cleveland Clinic, Cleveland, OH
| | - Eric A Youngstrom
- Department of Psychology, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | | | - Mary A Fristad
- Department of Psychiatry, The Ohio State University, Columbus, OH
| | - Boris Birmaher
- Department of Psychiatry, University of Pittsburgh Medical Center, Pittsburgh, PA
| | - Robert A Kowatch
- Department of Psychiatry, Ohio State Medical Center, Columbus, OH
| | - Eugene Arnold
- Department of Psychiatry, The Ohio State University, Columbus, OH
| | - David A Axelson
- Department of Psychiatry, University of Pittsburgh Medical Center, Pittsburgh, PA
| | - Neal Ryan
- Department of Psychiatry, University of Pittsburgh Medical Center, Pittsburgh, PA
| | - Jessica C Hauser
- Department of Psychiatry, The Ohio State University, Columbus, OH
| | - Daniel J Brace
- Department of Psychiatry, University of Pittsburgh Medical Center, Pittsburgh, PA
| | - Linda E Marsh
- Department of Psychiatry, Case Western Reserve University, Cleveland, OH
| | - Mary Kay Gill
- Department of Psychiatry, University of Pittsburgh Medical Center, Pittsburgh, PA
| | - Judith Depew
- Division of Psychiatry Cincinnati Children’s Hospital Medical Center, Cincinnati, OH
| | - Brieana M Rowles
- Department of Psychiatry, Case Western Reserve University, Cleveland, OH
| | - Sarah McCue Horwitz
- Department of Child and Adolescent Psychiatry, New York University School of Medicine, New York, NY, USA
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Weisler RH, Kalali AH, Cutler AJ, Gazda TD, Ginsberg L. Efficacy and Safety of Once- versus Twice-Daily Carbamazepine Extended-Release Capsules for the Treatment of Manic Symptoms in Patients with Bipolar I Disorder. Psychiatry (Edgmont) 2008; 5:35-48. [PMID: 22778707 PMCID: PMC3392099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
OBJECTIVE To compare the efficacy and safety of carbamazepine extended-release capsules (CBZ-ERC) administered twice daily (BID) versus once daily for the treatment of manic symptoms associated with bipolar I disorder in adults. DESIGN This was a Phase IIIb, randomized, double-blind, parallel-group, multicenter, 12-week study. Subjects were randomized (1:1) to CBZ-ERC once daily at bedtime (QHS) or BID. Dosing was initiated at CBZ-ERC 200mg/d and titrated to achieve an optimal dose (target dose, 800mg/d; maximum dose, 1600mg/d). The primary efficacy outcome variable was the Young Mania Rating Scale (YMRS). The Hamilton Rating Scale for Depression, 21-item version (HAM-D(21)), Montgomery-Åsberg Depression Rating Scale (MADRS), Clinical Global Impressions Scale-Bipolar Version (CGI-BP), and time to remission were secondary outcome variables. Safety measures included recording of adverse events, physical examination, vital signs (blood pressure, pulse rate, and weight), and clinical laboratory and electrocardiogram (ECG) parameters. RESULTS BID and QHS dosing were equally effective in improving symptoms of bipolar disorder, as measured with the YMRS, HAM-D(21), MADRS, and CGI-BP. Both BID and QHS dosing significantly improved total scores on the YMRS, HAM-D(21), and MADRS at all time points without statistically significant differences between groups. All three components of the CGI-BP improved during the study, and a large percentage of subjects in both groups achieved remission without significant differences between groups. Both CBZ-ERC regimens appeared to be safe and well tolerated. CONCLUSION These results suggest QHS dosing may be a safe and effective alternative to BID dosing of CBZ-ERC for treating manic episodes for many adults with bipolar I disorder, although additional studies are needed to confirm this finding.
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Affiliation(s)
- Richard H Weisler
- Dr. Weisler is from Duke University Medical Center, Durham, North Carolina, and University of North Carolina at Chapel Hill Departments of Psychiatry, Raleigh, North Carolina
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Duggal HS, Jagadheesan K, Gupta S, Basu S, Akhtar S, Nizamie HS. Intravenous valproate: a new perspective in the treatment of manic symptoms. Indian J Psychiatry 2002; 44:173-6. [PMID: 21206565 PMCID: PMC2954347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Over the last few years, the use of valproate in psychiatry has increased considerably. With the advent of oral loading dose strategy, its role in rapid treatment of acute mania has been demonstrated. The intravenous formulation of valproate, while retaining the rapidity of action of oral loading, also avoids some of the adverse effects of the oral preparation. Moreover, reports are pouring in that intravenous valproate loading may be more efficacious than oral valproate loading in the treatment of acute mania. We report two patients whose manic symptoms showed a dramatic response to intravenous valproate without adverse effects. The pharmacology of intravenous valproate and its clinical relevance to psychiatry are discussed.
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Affiliation(s)
- Harpreet S Duggal
- HARPREET S. DUGGAL, D.P.M., Resident, Central Institute of Psychiatry, Kanke. Ranchi-834006.
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